Health and the environment are connected issues for poor people in cities. They suffer more than their fair share of environmental burdens, from the effects of climate change to persistent local health problems due to poor water supplies, sanitation and housing. We need to address local environmental health inequalities without increasing global problems.

Research from the International Institute for Environment and Development, based in the UK, looks at urban health in low- and middle-income countries in relation to local and global environmental issues. It finds that the people most vulnerable to global environmental pressures are likely to be those already facing the greatest health risks as the result of local environmental burdens such as poor water supply, sanitation and housing. In fact, the health burden of climate change is highest in low-income countries and lowest in the affluent countries responsible for the change.

If well-being in cities is considered from the point of view of health rather than the economy, important differences appear. For example, a public policy designed to maximise health is fairer than one designed to maximise income since the same investment can bring greater health improvements to a poor family than to a rich family.

Historically, urban development has been partly driven by improvements in public health. Infectious diseases that came from bad infrastructure but threatened rich people led to improvements in housing and sanitation for poor people. Consequently, as societies moved from agricultural to industrial production and from rural to urban living, there was a transition from infectious diseases to non-infectious diseases such as cancer and heart disease.

Today, however, with few infections that rich people still need to fear, the challenge of providing basic water, sanitation and housing to deprived urban settlements has been neglected and remains poorly understood. Governments are also not paying enough attention to the new global environmental health threats:

• Acute respiratory diarrhoeal diseases and acute respiratory infections, the two major killers of young children, are made much worse by indoor air pollution and inadequate water supply and sanitation.
• Women and young children suffer disproportionately from such environment health problems: women are responsible for cooking on smoky stoves and children suffer most from acute respiratory infections and diarrhoea.
• Economic globalisation has brought global environmental changes including, most notably, climate change, which is changing the health risks from infectious diseases and increasing the likelihood of crop failures and famine.
• Urbanisation contributes to new health-related problems but if managed well should be a benefit to health.

Urban environments need to adapt to climate change in a way that deals with existing local environmental health issues. Local knowledge, experience in dealing with urban disasters and an understanding of other environmental hazards are important in building up resilience. The researcher concludes that:

• The cities that can already address the contemporary challenges of enabling urban poor people to acquire land, housing, water and sanitation will adapt more easily.
• Since climate change is partly due to a process of environmental displacement driven by economic growth, those who have benefited most from this have a responsibility to help vulnerable groups adapt.
• Measures to protect settlements that are likely to flood and measures to reduce vulnerability to increasing water scarcity will be less expensive if they are taken early, before investments are made in inappropriate infrastructures and locations.

Source(s):
‘Urban environments, wealth and health: shifting burdens and possible responses in low and middle-income nations,’ IIED Human Settlements Discussion Paper Series, Urban Environment 1, IIED: London, by Gordon McGranahan, 2007 (PDF) Full document.

Funded by: Rockerfeller Foundation; Sida; Danida

id21 Research Highlight: 15 February 2008

Further Information:
Gordon McGranahan
Human Settlements Programme
International Institute for Environment and Development
3 Endsleigh Street
London WC1H 0DD
UK

Tel: +44 (0)20 73882117
Fax: +44 (0)20 73882826
Contact the contributor: gordon.mcgranahan@iied.org

International Institute for Environment and Development, UK

Other related links:
'Editorial: climate change and cities'

'Unfairness in the causes and risks of climate change'

'Floods in Dhaka'

'Adaptation for India's cities'

'Durban adapts to climate change'

'Urban adaptation in Latin America'

'Cities vulnerable to sea level rise'